To reduce radiation dose in X-ray computed tomography (CT) imaging, one of the common strategies is to lower the milliampere-second (mAs) setting during projection data acquisition. However, this strategy would inevitably increase the projection data noise, and the resulting image by the filtered back-projection (FBP) method may suffer from excessive noise and streak artifacts. The edge-preserving nonlocal means (NLM) filtering can help to reduce the noise-induced artifacts in the FBP reconstructed image, but it sometimes cannot completely eliminate them, especially under very low-dose circumstance when the image is severely degraded. To deal with this situation, we proposed a statistical image reconstruction scheme using a NLM-based regularization, which can suppress the noise and streak artifacts more effectively. However, we noticed that using uniform filtering parameter in the NLM-based regularization was rarely optimal for the entire image. Therefore, in this study, we further developed a novel approach for designing adaptive filtering parameters by considering local characteristics of the image, and the resulting regularization is referred to as adaptive NLM-based regularization. Experimental results with physical phantom and clinical patient data validated the superiority of using the proposed adaptive NLM-regularized statistical image reconstruction method for low-dose X-ray CT, in terms of noise/streak artifacts suppression and edge/detail/contrast/texture preservation.